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1
Q

Migraine (complicated), Tension headache, Cluster headache, Pseudotumor cerebri, Trigeminal neuralgia, CNS vasculitis, Partial seizure, Intracranial neoplasm

A

CBC, ESR, CT—head, MRI—brain, LP

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2
Q 
Cluster headache
Migraine
Tension headache
Sinusitis
Pseudotumor cerebri
Trigeminal neuralgia
Intracranial neoplasm
A 
CBC
ESR
CT—head
MRI—brain
LP
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3
Q 
Temporal arteritis (giant cell 
arteritis)
Migraine
Cluster headache
Tension headache
Meningitis
Carotid artery dissection
Pseudotumor cerebri
Trigeminal neuralgia
Intracranial neoplasm
A 
CBC
ESR
CRP
Temporal artery biopsy
Doppler U/S—carotid
MRI—brain
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4
Q 
Sinusitis
Migraine
Tension headache
Meningitis
Intracranial neoplasm
A

CBC
XR—sinus
CT—sinus
LP

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5
Q 
Tension headache
Migraine
Depression
Caffeine or analgesic 
withdrawal
Hypertension
Cluster headache
Pseudotumor cerebri
Intracranial neoplasm
A 
CBC
Electrolytes
ESR
CT—head
LP
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6
Q 
Subarachnoid hemorrhage
Migraine
Meningitis/encephalitis
Intracranial hemorrhage
Vertebral artery dissection
Intracranial venous thrombosis
Acute hypertension
Intracranial neoplasm
A 
CT without contrast—head
LP
CBC
PT/PTT
MRI/MRA—brain
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7
Q 
Meningitis
Migraine
Subarachnoid hemorrhage
Sinusitis/encephalitis
Intracranial or epidural abscess
A 
CBC
CT—head
MRI—brain
LP—CSF analysis (cell count, 
protein, glucose, Gram stain
PCR for antigens, culture)
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8
Q 
Pseudotumor cerebri
Tension headache
Migraine
Cluster headache
Meningitis
Intracranial venous thrombosi
Intracranial neoplasm
A 
Urine hCG
CBC
CT—head
LP—opening pressure and CSF 
analysis
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9
Q 
Trigeminal neuralgia
Tension headache
Migraine
Cluster headache
TMJ dysfunction
Intracranial neoplasm
A

CBC
ESR
MRI—brain

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10
Q 
Alzheimer’s disease
Vascular dementia
Depression
Hypothyroidism
Chronic subdural hematoma
Normal pressure hydrocephalus
Intracranial neoplasm
B12 defi ciency
Neurosyphilis
A 
CBC
VDRL/RPR
Serum B12
TSH
MRI—brain (preferred)
CT—head
LP—CSF analysis (rare)
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11
Q 
Normal pressure 
hydrocephalus
Alzheimer’s disease
Vascular dementia
Chronic subdural hematoma
Intracranial neoplasm
Depression
B12 defi ciency
Neurosyphilis
Hypothyroidism
A 
CT—head
LP—opening pressure and CSF 
analysis
Serum B12
VDRL/RPR
TSH
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12
Q 
Creutzfeldt-Jakob disease
Vascular dementia
Lewy body dementia
Wernicke’s encephalopathy
Normal pressure hydrocephalus
Chronic subdural hematoma
Intracranial neoplasm
Depression
Delirium
B12 defi ciency
Neurosyphilis
A 
CBC, electrolytes, calcium
Serum B12
VDRL/RPR
MRI—brain (preferred)
CT—head
EEG
LP—CSF analysis
Brain biopsy
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13
Q 
Hypoglycemia
Transient ischemic attack
Arrhythmia
Delirium
Angina
A 
Glucose
CBC, electrolytes
Echocardiography
ECG
MRI—brain
Doppler U/S—carotid
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14
Q

Subdural hematoma
SIADH (causing hyponatremia)
Creutzfeldt-Jakob disease
Intracranial neoplasm

A

Electrolytes
CT—head
MRI—brain
LP

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15
Q 
Normal bereavement
Adjustment disorder with 
depressed mood
Major depressive disorder with 
psychotic features
Schizoaffective disorder
Depressive disorder not 
otherwise specifi ed (NOS)
A 
Physical exam
Mental status exam
TSH
CBC
Urine toxicology
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16
Q

Major depressive disorder
Substance-induced mood
disorder
Dysthymic disorder

A 
Physical exam
Mental status exam
Blood alcohol level
TSH
CBC
Urine toxicology
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17
Q

Major depressive disorder
Substance-induced mood
disorder
Dysthymic disorder

A 
Physical exam
Mental status exam
Blood alcohol level
TSH
CBC
Urine toxicology
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18
Q 
Bipolar I disorder
Bipolar II disorder
Cyclothymic disorder
Major depressive disorder
Schizoaffective disorder
A

Physical exam
Mental status exam
Urine toxicology

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19
Q 
Schizophrenia
Schizoid or schizotypal 
personality disorder
Schizophreniform disorder
Psychotic disorder due to a 
general medical condition
Substance-induced psychosis
Depression with psychotic 
features
A 
Mental status exam
Urine toxicology
TSH
CBC
Electrolytes
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20
Q 
Substance-induced psychosis
Brief psychotic disorder
Schizophreniform disorder
Schizophrenia
Psychotic disorder due to a 
general medical condition
A 
Urine toxicology
Mental status exam
TSH
CBC
Electrolytes, BUN/Cr, AST/
ALT
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21
Q 
Schizoaffective disorder
Mood disorder with psychotic 
features
Schizophrenia
Schizophreniform disorder
Psychotic disorder due to a 
general medical condition
A 
Mental status exam
Beck Depression Inventory
TSH
CBC
Electrolytes
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22
Q 
Ménière’s disease
Vestibular neuronitis
Labyrinthitis
Benign positional vertigo
Acoustic neuroma
A

CBC
VDRL/RPR (syphilis is a cause
of Ménière’s disease)
MRI—brain

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23
Q 
Orthostatic hypotension due 
to dehydration (diarrhea, 
diuretic use)
Vestibular neuronitis
Labyrinthitis
Benign positional vertigo
Vertebrobasilar insuffi ciency
A 
Orthostatic vital signs
CBC
Electrolytes
Stool exam (occult blood, fecal 
leukocytes)
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24
Q 
Drug-induced orthostatic 
hypotension
Vestibular neuronitis
Labyrinthitis
Benign positional vertigo
Brain stem or cerebellar tumor
Acute renal failure
A 
Orthostatic vital signs
CBC
Electrolytes
BUN/Cr
MRI—brain
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25
Benign positional vertigo Vestibular neuronitis Labyrinthitis Ménière’s disease
MRI—brain | Audiogram
26
``` Vestibular neuronitis Labyrinthitis Ménière’s disease Benign positional vertigo Vertigo associated with cervical spine disease/injury Vertebrobasilar insuffi ciency ```
CBC Electrolytes Electronystagmography MRI/MRA—brain
27
``` Labyrinthitis Vestibular neuronitis Ménière’s disease Acoustic neuroma Vertebrobasilar insufficiency ```
Audiogram Electronystagmography MRI/MRA—brain
28
``` Seizure, grand mal (now called complex tonic-clonic seizure) Convulsive syncope Substance abuse/overdose Malingering Hypoglycemia ```
``` CBC, electrolytes, glucose Urine toxicology EEG MRI—brain CT—head LP—CSF analysis ECG ```
29
``` Drug-induced orthostatic hypotension (causing syncope) Cardiac arrhythmia Syncope (vasovagal, other causes) Stroke MI Pulmonary embolism ```
``` Orthostatic vital signs CBC Electrolytes CT—head ECG V/Q scan CT—chest with IV contrast ```
30
``` Cardiac arrhythmia (causing syncope) Severe aortic stenosis Syncope (other causes) Seizure Pulmonary embolism ```
``` ECG Holter monitoring CBC, electrolytes Glucose Echocardiography CT—head ```
31
``` Transient ischemic attack (TIA) Hypoglycemia Seizure Stroke Facial nerve palsy ```
``` CBC Glucose Electrolytes ECG CT—head MRI—brain Doppler U/S—carotid Echocardiography EEG ```
32
``` Stroke TIA Seizure Intracranial neoplasm Subdural or epidural hematoma ```
``` CBC, electrolytes PT/PTT CT—head MRI—brain (preferred) Doppler U/S—carotid Echocardiography ```
33
``` Guillain-Barré syndrome Multiple sclerosis Polymyositis Myasthenia gravis Peripheral neuropathy Tumor in the vertebral canal ```
``` CBC, electrolytes CPK LP—CSF analysis MRI—spine EMG/nerve conduction study Tensilon test Serum B12 ```
34
``` Multiple sclerosis Stroke Conversion disorder Malingering CNS tumor Neurosyphilis Syringomyelia CNS vasculitis ```
``` CBC, ESR VDRL/RPR MRI—brain LP—CSF analysis Retinal evoked potentials ```
35
``` Diabetic peripheral neuropathy Alcoholic peripheral neuropathy B12 defi ciency Hypocalcemia Hyperventilation Paraproteinemia/myeloma ```
``` HbA1c ESR Calcium Serum B12 Serum and urine protein electrophoresis ```
36
``` Myasthenia gravis Horner’s syndrome Multiple sclerosis Intracranial tumor compressing CN III, IV, or VI Amyotrophic lateral sclerosis ```
``` Tensilon test ACh receptor antibodies (in serum) CXR CT—chest MRI—brain EMG ```
37
``` Todd’s paralysis TIA Stroke Complicated migraine Malingering ```
CBC, electrolytes EEG MRI—brain Doppler U/S—carotid
38
Depression Adjustment disorder Hypothyroidism Anemia
``` CBC TSH HIV/STD testing (given husband’s possible risk factors) ```
39
``` Post-traumatic stress disorder (PTSD) Depression Generalized anxiety disorder Psychotic or delusional disorder Hypothyroidism ```
CBC TSH Calcium Urine toxicology
40
``` Colon cancer Hypothyroidism Renal failure Hypercalcemia Depression ```
``` Rectal exam, stool for occult blood CBC, electrolytes, calcium, BUN/Cr, AST/ALT, TSH Colonoscopy Barium enema ```
41
Hypothyroidism Depression Diabetes Anemia
TSH, FT3,FT4 CBC Glucose, HbA1c
42
Obstructive sleep apnea Hypothyroidism Chronic fatigue syndrome Narcolepsy
``` CBC TSH Nocturnal pulse oximetry Polysomnography ECG ```
43
Diabetes mellitus Atypical depression Primary polydipsia Diabetes insipidus
Glucose tolerance test, HbA1c UA CBC, electrolytes, glucose BUN/Cr
44
Sleep deprivation Sleep apnea Depression Anemia
CBC Nocturnal pulse oximetry Polysomnography
45
``` Tuberculosis Acute HIV infection Lymphoma Leukemia Hyperthyroidism ```
``` PPD CBC CXR Sputum Gram stain, acid-fast stain, and culture HIV antibody TSH, FT4 ```
46
``` Stress-induced insomnia Caffeine-induced insomnia Insomnia with circadian rhythm sleep disorder Insomnia related to major depressive disorder ```
``` Polysomnography Mental status exam Urine toxicology CBC TSH ```
47
``` Obstructive sleep apnea Daytime fatigue in primary hypersomnia Insomnia with circadian rhythm sleep disorder Insomnia related to major depressive disorder ```
CBC TSH Polysomnography ECG
48
``` Insomnia related to major depressive disorder Primary hypersomnia Insomnia with circadian rhythm sleep disorder ```
Mental status exam TSH CBC Polysomnography
49
``` Infectious mononucleosis Hepatitis Viral or bacterial pharyngitis Acute HIV infection Secondary syphilis ```
``` CBC, peripheral smear Monospot test Throat culture AST/ALT/bilirubin/alkaline phosphatase HIV antibody and viral load Anti-EBV antibodies VDRL/RPR ```
50
``` HIV, acute retroviral syndrome Infectious mononucleosis Hepatitis Viral pharyngitis Streptococcal tonsillitis/ scarlet fever Secondary syphilis ```
``` CBC Peripheral smear HIV antibody and viral load CD4 count Monospot test Throat culture VDRL/RPR AST/ALT/bilirubin/alkaline phosphatase ```
51
``` Pharyngitis (bacterial or viral) Mycoplasma pneumonia Acute HIV infection Infectious mononucleosis ```
``` Throat swab for culture and rapid streptococcal antigen Monospot test CBC HIV antibody and viral load ```
52
``` Asthma GERD Bronchitis Pneumonitis Foreign body ```
``` CBC CXR Peak fl ow measurement PFTs Methacholine challenge test ```
53
COPD—chronic bronchitis Bronchiectasis Lung cancer Tuberculosis
``` CBC Sputum Gram stain and culture CXR PFTs CT—chest PPD ```
54
``` Pneumonia Bronchitis Lung abscess Lung cancer Tuberculosis Pericarditis ```
``` CBC Sputum Gram stain and culture CXR CT—chest ECG PPD ```
55
``` Atypical pneumonia Reactive airway disease URI-associated (“postinfectious”) Postnasal drip GERD ```
``` CBC Induced sputum Gram stain and culture CXR IgM detection for Mycoplasma pneumoniae Urine Legionella antigen ```
56
``` Lung cancer Tuberculosis Lung abscess COPD Vasculitis (i.e., Wegener’s) Interstitial lung disease CHF ```
``` CBC Sputum Gram stain, culture, and cytology CXR CT—chest PPD Bronchoscopy ```
57
``` COPD exacerbation (bronchitis) Lung cancer Pneumonia URI CHF ```
``` CBC CXR PFTs Sputum Gram stain and culture CT—chest ```
58
``` Tuberculosis Pneumonia Lung abscess Vasculitis Lymphoma Metastatic cancer HIV/AIDS Sarcoidosis ```
``` CBC PPD Sputum Gram stain, acid-fast stain, and culture CXR CT—chest Bronchoscopy HIV antibody ```
59
``` Tuberculosis Pneumonia (including Pneumocystis jiroveci) Bronchitis CHF (cardiomyopathy) Asthma Acute HIV infection ```
``` CBC PPD Sputum Gram stain, acid-fast stain, silver stain, and culture CXR HIV antibody ```
60
``` CHF Cardiac valvular disease GERD Pulmonary fi brosis COPD Postnasal drip ```
``` CBC CXR ECG Echocardiography PFTs BNP ```
61
``` Myocardial infarction (MI) GERD Angina Costochondritis Aortic dissection Pericarditis Pulmonary embolism Pneumothorax ```
``` ECG CPK-MB, troponin CXR CBC, electrolytes Echocardiography Cardiac catheterization ```
62
``` Sickle cell disease—pulmonary infarction Pneumonia Pulmonary embolism MI Pneumothorax Aortic dissection ```
``` CBC, reticulocyte count, LDH, peripheral smear ABG CXR CPK-MB, troponin ECG CT—chest with IV contrast ```
63
``` GERD Esophagitis Peptic ulcer disease Esophageal spasm MI Angina ```
ECG Barium swallow Upper endoscopy Esophageal pH monitoring
64
Angina Esophageal spasm Esophagitis
``` ECG CPK-MB, troponin CXR CBC, electrolytes Exercise stress test Upper endoscopy/pH monitor Cardiac catheterization ```
65
``` Pericarditis Aortic dissection MI Costochondritis GERD Esophageal rupture ```
``` ECG CPK-MB, troponin CXR Echocardiography CBC Upper endoscopy ```
66
``` Costochondritis Pneumonia MI Pulmonary embolism Pericarditis Muscle strain ```
ECG CPK-MB, troponin CXR CBC
67
``` Pulmonary embolism Pneumonia Costochondritis MI CHF Aortic dissection ```
``` ECG CXR ABG CPK-MB, troponin CBC, electrolytes CT—chest with IV contrast Doppler U/S—legs D-dimer ```
68
``` Aortic dissection MI Pericarditis Esophageal rupture Esophageal spasm GERD Pancreatitis Fat embolism ```
``` ECG, CPK-MB, troponin CXR CBC, amylase, lipase Transesophageal echocardiography (TEE), MRI/MRA—aorta Aortic angiography Upper endoscopy ```
69
``` Hypoglycemia Cardiac arrhythmias Angina Hyperthyroidism Hyperventilation episodes Panic attacks Pheochromocytoma Carcinoid ```
``` Glucose CBC, electrolytes TSH BUN/Cr ECG Holter monitor ```
70
``` Hyperthyroidism Cancer HIV infection Dieting/diet drugs Anorexia nervosa Malabsorption ```
TSH, FT4 CBC, electrolytes HIV antibody Urine toxicology
71
``` Smoking cessation Drug side effect Hypothyroidism Cushing’s syndrome Polycystic ovary syndrome Diabetes mellitus Atypical depression ```
CBC, electrolytes, glucose TSH 24-hour urine free cortisol Dexamethasone suppression test
72
``` Esophageal cancer Achalasia Esophagitis Systemic sclerosis Esophageal stricture Amyotrophic lateral sclerosis ```
``` CBC CXR Endoscopy with biopsy Barium swallow CT—chest ```
73
``` Plummer-Vinson syndrome Esophageal cancer Esophagitis Achalasia Systemic sclerosis Mitral valve stenosis ```
CBC Serum iron, ferritin, TIBC Barium swallow Endoscopy
74
``` Achalasia Plummer-Vinson syndrom Esophageal cancer Esophagitis Systemic sclerosis Mitral valve stenosis Esophageal stricture Zenker’s diverticulum ```
CXR Endoscopy Barium swallow Esophageal manometry
75
``` Esophagitis (CMV, HSV, pill- induced) Systemic sclerosis GERD Esophageal stricture Zenker’s diverticulum ```
``` CBC Endoscopy Barium swallow HIV antibody CD4 count ```
76
``` Pregnancy Gastritis Hypercalcemia Diabetes mellitus UTI Depression ```
``` Urine hCG Pelvic exam U/S—pelvis CBC, electrolytes, calcium, glucose UA, urine culture Baseline Pap smear, cervical cultures, rubella antibody, HIV antibody, hepatitis B surface antigen, and VDRL/ RPR ```
77
Nephrolithiasis Renal cell carcinoma Pyelonephritis GI etiology (e.g., appendicitis)
``` Rectal exam UA Urine culture and sensitivity BUN/Cr CT—abdomen U/S—renal IVP ```
78
``` Pancreatic cancer Acute viral hepatitis Chronic pancreatitis Cholecystitis/choledocholithiasis Abdominal aortic aneurysm Peptic ulcer disease ```
``` Rectal exam CBC, electrolytes Amylase and lipase AST/ALT/bilirubin/alkaline phosphatase U/S—abdomen CT—abdomen ```
79
``` Acute pancreatitis Peptic ulcer disease Cholecystitis/choledocholithiasis Gastritis Abdominal aortic aneurysm Mesenteric ischemia Alcoholic hepatitis Mallory-Weiss tear ```
``` Rectal exam CBC, electrolytes, BUN/Cr, amylase, lipase, AST/ALT/ bilirubin/alkaline phosphatase U/S—abdomen CT—abdomen Upper endoscopy ECG ```
80
``` Rectal exam CBC, electrolytes, BUN/Cr, amylase, lipase, AST/ALT/ bilirubin/alkaline phosphatase U/S—abdomen CT—abdomen Upper endoscopy ECG ```
``` Rectal exam CBC AST/ALT/bilirubin/alkaline phosphatase U/S—abdomen HIDA scan ```
81
``` Ascending cholangitis Acute cholecystitis Hepatitis Choledocholithiasis Sclerosing cholangitis Fitz-Hugh–Curtis syndrome ```
``` Rectal exam CBC AST/ALT/bilirubin/alkaline phosphatase Viral hepatitis serologies U/S—abdomen MRCP ERCP ```
82
``` Acute hepatitis Acute cholecystitis Ascending cholangitis Choledocholithiasis Pancreatitis Acute glomerulonephritis ```
``` Rectal exam CBC, amylase, lipase AST/ALT/bilirubin/alkaline phosphatase UA Viral hepatitis serologies U/S—abdomen ```
83
``` Peptic ulcer disease Gastritis GERD Cholecystitis Chronic pancreatitis Mesenteric ischemia ```
``` Rectal exam Amylase, lipase, lactate AST/ALT/bilirubin/alkaline phosphatase Endoscopy (including H. pylori testing) Upper GI series ```
84
``` Peptic ulcer perforation Acute pancreatitis Hepatitis Cholecystitis Choledocholithiasis Mesenteric ischemia ```
``` Rectal exam CBC, electrolytes, amylase, lipase, lactate AST/ALT/bilirubin/alkaline phosphatase AXR Upright CXR Endoscopy (including H. pylori testing) ```
85
``` Splenic rupture Kidney stone Rib fracture Pneumonia Perforated peptic ulcer Splenic infarct ```
``` Rectal exam CBC, electrolytes CXR CT—abdomen U/S—abdomen ```
86
``` Intestinal obstruction Small bowel or colon cancer Volvulus of the bowel Gastroenteritis Food poisoning Ileus Hernia ```
``` Rectal exam CBC, electrolytes AXR CT—abdomen/pelvis CXR ```
87
``` Mesenteric ischemia/infarction Diverticulitis Peptic ulcer disease Gastroenteritis Acute pancreatitis Cholecystitis/choledocholithiasis MI ```
``` Rectal exam CBC, amylase, lipase, lactate ECG, CPK-MB, troponin AXR CT—abdomen Mesenteric angiography Barium enema ```
88
``` Ovarian torsion Appendicitis Nephrolithiasis Ectopic pregnancy Ruptured ovarian cyst PID Bowel infarction or perforation ```
``` Pelvic exam Rectal exam Urine hCG UA CBC Doppler U/S—pelvis CT—abdomen Laparoscopy ```
89
``` Diverticulitis Crohn’s disease Ulcerative colitis Gastroenteritis Abscess ```
``` Rectal exam CBC, electrolytes CXR AXR CT—abdomen ```
90
``` Acute appendicitis Gastroenteritis Diverticulitis Crohn’s disease Nephrolithiasis Volvulus or other intestinal obstruction/perforation ```
``` Rectal exam CBC, electrolytes AXR CT—abdomen U/S—abdomen ```
91
``` Irritable bowel syndrome Crohn’s disease Celiac disease Chronic pancreatitis GI parasitic infection (amebiasis, giardiasis) Endometriosis ```
``` Rectal exam, stool for occult blood Pelvic exam Urine hCG CBC Electrolytes CT—abdomen/pelvis Stool for ova and parasitology Entamoeba histolytica antigen ```
92
``` PID Endometriosis Dysmenorrhea Vaginitis Cystitis Spontaneous abortion Pyelonephritis ```
``` Pelvic exam Rectal exam Urine hCG Cervical cultures CBC/ESR UA, urine culture U/S—pelvis ```
93
``` Colorectal cancer Irritable bowel syndrome Diverticulosis GI parasitic infection (ascariasis, giardiasis) Infl ammatory bowel disease Angiodysplasia ```
``` Rectal exam CBC AST/ALT/bilirubin/alkaline phosphatase Colonoscopy Barium enema CT—abdomen/pelvis ```
94
``` Low-fi ber diet Irritable bowel syndrome Substance abuse (e.g., heroin) Depression Hypothyroidism ```
Rectal exam TSH Electrolytes Urine toxicology
95
``` Irritable bowel syndrome Infl ammatory bowel disease Celiac disease Chronic pancreatitis GI parasitic infection (ascariasis, giardiasis) Lactose intolerance ```
``` Rectal exam, stool for occult blood CBC Electrolytes Stool for ova and parasitology AXR CT—abdomen/pelvis ```
96
``` Infectious diarrhea (gastroenteritis)—bacterial, viral, parasitic, protozoal Food poisoning Infl ammatory bowel disease ```
``` Rectal exam, stool for occult blood Stool leukocytes and culture CBC Electrolytes CT—abdomen/pelvis ```
97
``` Pseudomembranous (Clostridium diffi cile) colitis Gastroenteritis Cryptosporidiosis Food poisoning Infl ammatory bowel disease ```
``` Rectal exam Stool leukocytes, culture, occult blood C. diffi cile toxin in stool Electrolytes ```
98
``` Traveler’s diarrhea Giardiasis Amebiasis Food poisoning Hepatitis A ```
``` Rectal exam Stool leukocytes, culture, Giardia antigen, Entamoeba histolytica antigen Electrolytes AST/ALT/bilirubin/alkaline phosphatase Viral hepatitis serology ```
99
``` Lactose intolerance Gastroenteritis Infl ammatory bowel disease Irritable bowel syndrome Hyperthyroidism ```
Rectal exam Stool exam Hydrogen breath test TSH
100
``` Crohn’s disease Gastroenteritis Ulcerative colitis Celiac disease Pseudomembranous colitis Hyperthyroidism Small bowel lymphoma Carcinoid ```
``` Rectal exam Stool exam and culture CBC, electrolytes TSH CT—abdomen Colonoscopy Small bowel series Urinary 5-HIAA ```
101
Bleeding peptic ulcer Gastritis Gastric cancer Esophageal varices
``` Rectal exam CBC, electrolytes AST/ALT/bilirubin/alkaline phosphatase Endoscopy (including H. pylori testing if ulcer is confi rmed) ```
102
``` Gastritis Bleeding peptic ulcer Gastric cancer Esophageal varices Mallory-Weiss tear ```
``` Rectal exam CBC, electrolytes AST/ALT/bilirubin/alkaline phosphatase Barium swallow Endoscopy ```
103
``` Colorectal cancer Anal fi ssure Hemorrhoids Diverticulosis Ischemic bowel disease Angiodysplasia Upper GI bleeding Infl ammatory bowel disease ```
``` Rectal exam CBC, PT/PTT AST/ALT/bilirubin/alkaline phosphatase CEA Colonoscopy CT—abdomen/pelvis Barium enema ```
104
``` Ulcerative colitis Crohn’s disease Proctitis Anal fi ssure Hemorrhoids Diverticulosis Dysentery ```
``` Rectal exam CBC, PT/PTT AXR Colonoscopy CT—abdomen/pelvis Barium enema ```
105
``` Diverticulosis Anal fi ssure Hemorrhoids Angiodysplasia Colorectal cancer ```
``` Rectal exam CBC, PT/PTT Electrolytes Colonoscopy CT—abdomen/pelvis ```
106
``` Bladder cancer Renal cell carcinoma Nephrolithiasis Acute glomerulonephritis Prostate cancer Coagulation disorder (i.e., factor VIII antibodies) Polycystic kidney disease ```
``` Genitourinary exam UA, urine cytology BUN/Cr, PSA, CBC, PT/PTT Cystoscopy U/S—renal/bladder CT—abdomen/pelvis IVP ```
107
``` Polycystic kidney disease Nephrolithiasis Acute glomerulonephritis (e.g. IgA nephropathy) UTI Coagulation disorder Bladder cancer ```
``` Genitourinary exam UA BUN/Cr, PSA, CBC, PT/PTT U/S—renal CT—abdomen/pelvis IVP ```
108
``` Renal cell carcinoma Bladder cancer Nephrolithiasis Acute glomerulonephritis Pyelonephritis Prostate cancer ```
``` Genitourinary, rectal exam UA, urine cytology, BUN/Cr, PSA, CBC, PT/PTT U/S—renal CT—abdomen/pelvis IVP ```
109
``` Benign prostatic hyperplasia (BPH) Prostate cancer UTI Bladder stones ```
Rectal exam UA CBC, BUN/Cr, PSA U/S—prostate (transrectal)
110
``` Prostate cancer BPH Renal cell carcinoma UTI Bladder stones ```
``` Rectal exam UA CBC, BUN/Cr, PSA U/S—prostate (transrectal) CT—pelvis IVP ```
111
Urethritis Cystitis Prostatitis
``` Genital ± rectal exam UA Urine culture Gram stain and culture of urethral discharge Chlamydia and gonorrhea PCR ```
112
Acute pyelonephritis Nephrolithiasis Renal cell carcinoma Lower UTI (cystitis, urethritis)
``` UA Urine culture and sensitivity CBC, BUN/Cr U/S—renal CT—abdomen ```
113
``` Drug-related ED ED caused by hypertension ED caused by diabetes mellitus Psychogenic ED Peyronie’s disease ```
Genital exam Rectal exam Glucose CBC
114
``` Pregnancy Anovulatory cycle Hyperprolactinemia UTI Thyroid disease ```
``` Pelvic exam Urine hCG U/S—pelvis CBC, electrolytes UA, urine culture Prolactin, TSH Baseline Pap smear, cervical cultures, rubella antibody, HIV antibody, hepatitis B surface antigen, and VDRL/ RPR ```
115
``` Polycystic ovary syndrome Thyroid disease Hyperprolactinemia Pregnancy Ovarian or adrenal malignancy Premature ovarian failure ```
``` Pelvic exam Urine hCG U/S—pelvis LH/FSH, TSH, prolactin Testosterone, DHEAS ```
116
``` Amenorrhea secondary to prolactinoma Pregnancy Thyroid disease Premature ovarian failure Pituitary tumor ```
``` Pelvic and breast exam Urine hCG Prolactin LH/FSH, TSH MRI—brain ```
117
Menopause Pregnancy Pituitary tumor Thyroid disease
``` Pelvic exam Urine hCG LH/FSH, TSH, prolactin, testosterone, DHEAS CBC MRI—brain ```
118
``` Sheehan’s syndrome Premature ovarian failure Pituitary tumor Thyroid disease Asherman’s syndrome ```
``` Pelvic exam Urine hCG CBC LH/FSH, prolactin TSH, FT4 ACTH MRI—brain Hysteroscopy ```
119
Anorexia nervosa
``` CBC TSH FT4 ACTH FSH LH ```
120
Anxiety-induced amenorrhea
``` CBC TSH FT4 ACTH Urine cortisol level Progesterone challenge test FSH/LH/estradiol levels ```
121
``` Dysfunctional uterine bleeding Coagulation disorders (e.g., von Willebrand’s disease, hemophilia) Cervical cancer Molar pregnancy Hypothyroidism Diabetes mellitus ```
``` Pelvic exam Urine hCG Cervical cultures, Pap smear CBC, ESR, glucose PT/PTT Prolactin, LH/FSH TSH U/S—pelvis ```
122
``` Endometrial cancer Cervical cancer Atrophic endometrium Endometrial hyperplasia Endometrial polyps Atrophic vaginitis ```
``` Pelvic exam Pap smear Endometrial biopsy U/S—pelvis Endometrial curettage Colposcopy Hysteroscopy ```
123
``` Cervical cancer Cervical polyp Cervicitis Trauma (e.g., cervical laceration) ```
Pelvic exam Pap smear Colposcopy and biopsy
124
Spontaneous abortion Ectopic pregnancy Molar pregnancy
``` Pelvic exam Urine hCG U/S—pelvis CBC, PT/PTT Quantitative serum hCG ```
125
Ectopic pregnancy Ruptured ovarian cyst Ovarian torsion PID
``` Pelvic exam Urine hCG Cervical cultures U/S—pelvis Quantitative serum hCG ```
126
``` Bacterial vaginosis Vaginitis—candidal Vaginitis—trichomonal Cervicitis (chlamydia, gonorrhea) ```
``` Pelvic exam Wet mount Cervical cultures KOH prep (“whiff test”) pH of vaginal fluid ```
127
Vaginitis—candidal Bacterial vaginosis Vaginitis—trichomonal
``` Pelvic exam KOH prep (“whiff test”) Wet mount Cervical cultures pH of vaginal fluid ```
128
``` Vaginitis—trichomonal Vaginitis—candidal Bacterial vaginosis Cervicitis (chlamydia, gonorrhea) ```
``` Pelvic exam Wet mount Cervical cultures pH of the vaginal fluid KOH prep (“whiff test”) ```
129
``` Atrophic vaginitis Endometriosis Cervicitis Depression Domestic abuse ```
Pelvic exam Wet mount, KOH prep, cervical cultures U/S—pelvis
130
``` Endometriosis Cervicitis Vaginismus Vulvodynia PID Depression Domestic violence ```
``` Pelvic exam Wet mount, KOH prep, cervical cultures U/S—pelvis Laparoscopy ```
131
``` Domestic violence Osteogenesis imperfecta Substance abuse Consensual violent sexual behavior ```
XR—skeletal survey CT—maxillofacial Urine toxicology CBC
132
Rape
``` Pelvic exam Urine hCG Wet mount, KOH prep, cervical cultures XR—skeletal survey CBC HIV antibody Viral hepatitis serologies ```
133
Domestic violence Factitious disorder Substance abuse
XR—wrist CT—head Urine toxicology
134
``` Carpal tunnel syndrome Median nerve compression in forearm or arm Radiculopathy of nerve roots C6 and C7 in cervical spine ```
Nerve conduction study | EMG
135
``` Systemic lupus erythematosus (SLE) Rheumatoid arthritis Psoriatic arthritis Parvovirus B19 infection ```
``` ANA, anti-dsDNA, ESR, C3, C4, rheumatoid factor (RF), CBC XR—hands UA ```
136
``` Rheumatoid arthritis SLE Disseminated gonorrhea Arthritis associated with infl ammatory bowel disease Osteoarthritis ```
``` ANA, anti-dsDNA, ESR, RF, CBC XR—hands, left knee Cervical culture Arthrocentesis and synovial fluid analysis ```
137
Psoriatic arthritis Rheumatoid arthritis SLE
``` RF, ANA, ESR CBC XR—hands XR—pelvis/sacroiliac joints Uric acid ```
138
Hip fracture Hip dislocation Pelvic fracture
``` XR—hip/pelvis CT or MRI—hip CBC Serum calcium and vitamin D Bone density scan (DEXA) ```
139
Hip dislocation—traumatic | Hip fracture
``` XR—hip CT or MRI—hip CBC PT/PTT Blood type and cross-match Urine toxicology and blood alcohol level ```
140
Osteoarthritis Pseudogout Gout Meniscal or ligament damage
``` XR—knee CBC ESR Knee arthrocentesis and synovial fl uid analysis (cell count, Gram stain, culture, crystals) MRI—knee ```
141
``` Septic arthritis Gout Pseudogout Lyme arthritis Trauma Reiter’s arthritis ```
``` CBC Knee arthrocentesis and synovial fl uid analysis (see above) Blood, urethral cultures XR—knee Uric acid Lyme antibody ```
142
Stress fracture Plantar fasciitis Foot sprain or strain
XR—foot Bone scan—foot MRI—foot
143
Plantar fasciitis Heel fracture Splinter/foreign body
XR—heel | Bone scan
144
Tennis elbow (lateral epicondylitis) Stress fracture
XR—arm Bone scan MRI—elbow
145
``` Disseminated gonorrhea Rheumatoid arthritis SLE Psoriatic arthritis Reiter’s arthritis ```
``` Knee arthrocentesis and synovial fl uid analysis (cell count, Gram stain, culture) ANA, anti-dsDNA, ESR, RF, CBC Blood, cervical cultures XR—knee ```
146
``` Peripheral vascular disease (intermittent claudication) Leriche’s syndrome (aortoiliac occlusive disease) Lumbar spinal stenosis (pseudoclaudication) Osteoarthritis ```
Ankle-brachial index Doppler U/S—lower extremity Angiography MRI—lumbar spine
147
``` DVT Baker’s cyst rupture Myositis Cellulitis Superfi cial venous thrombosis ```
``` Doppler U/S—right leg CBC CPK D-dimer PT, aPTT, fibrinogen XR—right leg ```
148
Angina/MI Tendonitis Osteoarthritis Shoulder dislocation
``` CPK-MB, troponin, ECG CBC ESR XR—shoulder CXR Echocardiography Stress test ```
149
Shoulder dislocation Fracture of the humerus Rotator cuff injury
XR—shoulder XR—arm MRI—shoulder
150
``` Rhabdomyolysis due to simvastatin or clofibrate Polymyositis Inclusion body myositis Thyroid disease ```
``` CBC CPK Aldolase UA Urine myoglobin TSH ```
151
Disk herniation Lumbar muscle strain Tumor in the vertebral canal
XR—L-spine | MRI—L-spine
152
Lumbar muscle strain Disk herniation Abdominal aortic aneurysm Vertebral compression fracture
XR—L-spine
153
Lumbar spinal stenosis Lumbar muscle strain Tumor in the vertebral canal Peripheral vascular disease
``` XR—L-spine MRI—L-spine (preferred) CT—L-spine Ankle-brachial index ```
154
``` Malingering Lumbar muscle strain Disk herniation Knee or leg fracture Ankylosing spondylitis ```
XR—L-spine/knee | MRI—L-spine
155
Neonatal sepsis Meningitis Pneumonia UTI
``` Physical exam CBC, electrolytes UA Urine culture Blood culture CXR LP—CSF analysis ```
156
Acute otitis media URI Meningitis UTI
Physical exam (including pneumatic otoscopy) CBC UA
157
``` Measles (or other viral exanthem) Rubella Roseola Fifth disease Varicella Scarlet fever Meningitis ```
``` Physical exam CBC Viral antibodies/titers Throat swab for culture LP ```
158
``` Gastroenteritis (viral, bacterial, parasitic) Food poisoning UTI URI Volvulus Intussusception ```
``` Physical exam Stool exam and culture CBC Electrolytes UA, urine culture AXR ```
159
``` Attention-deficit hyperactivity disorder (ADHD) Oppositional defiant disorder Manic episode Conduct disorder ```
Physical exam | Mental status exam
160
``` Adjustment disorder Substance intoxication/abuse/ dependence Manic episode Oppositional defiant disorder Conduct disorder ```
Physical exam Mental status exam Urine toxicology
161
Substance abuse Conduct disorder Oppositional defiant disorder Adjustment disorder
Urine toxicology | Mental status exam
162
Age-appropriate behavior ADHD Oppositional defiant disorder
Physical exam | Mental status exam

Step2 CS (4 decks)

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